Potential driving issues in combat returnees

Defense and Veterans Brain Injury Center (DVBIC), Richmond, VA, USA.
Neurorehabilitation (Impact Factor: 1.12). 01/2010; 26(3):271-8. DOI: 10.3233/NRE-2010-0562
Source: PubMed


The driving abilities of service members returning from Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) have not been well reported and are an important aspect of their return to normal life. This article reviews the unique risk factors for unsafe driving in this cohort. In particular, the cognitive and psychological symptoms of mild traumatic brain injury and postraumatic stress disorder, two of the most common diagnoses affecting these returning warriors, are specified, and their possible association with impaired driving is examined. The potential negative impact of the "battlemind driving tactics" (i.e., evasive driving skills) acquired by these service members as part of their military tours is also highlighted. The article concludes with comments about the functional consequences of impaired driving in this population, including limits to participation in rehabilitation and community reintegration, as well as recognition of the need for further research in this area.

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Available from: Melissa M Amick, May 20, 2014
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    • "Other authors have attributed postdeployment driving stress to the evasive or battlefield driving tactics taught to military personnel before deployment, including speeding, driving down the center of or off the road, swerving around objects in the road, ignoring traffic signals and signs (to avoid attack), and not wearing a seatbelt (to enable a quick escape; Lew et al., 2010; Stern et al., 2011). These driving behaviors, taught as life-saving techniques, are strongly reinforced during deployment to such a degree that they may become automatic driving habits (Stern et al., 2011). "
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    ABSTRACT: Difficulty in driving after deployment has emerged as an impediment for servicemembers returning from Operation Iraqi Freedom and Operation Enduring Freedom (OIF-OEF). This study explored postdeployment driving stress and related occupational limitations using two self-report instruments: the Driver's Stress Profile and the Driving and Occupational Limitations questionnaire. Data gathered from 103 OIF-OEF returnees confirmed that driving and related occupational issues occur postdeployment. Significant low to moderate correlations were found between postdeployment driving stress and limitations in community mobility, leisure, and social participation. The returnees who drove off base more frequently during deployment showed significantly higher levels of postdeployment driving stress than the returnees who drove off base less frequently. Moreover, the returnees who demonstrated higher levels of driving stress and occupational limitations required more time to resume normal driving postdeployment. Findings raise awareness about the need to design effective driver rehabilitation and community reintegration programs for this population.
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    ABSTRACT: We studied the prevalence and characteristics of self-reported driving difficulties and examined their association with traumatic brain injury (TBI) and/or posttraumatic stress disorder (PTSD) in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) veterans who were seen at a Department of Veterans Affairs outpatient polytrauma clinic. In this study, we used a brief driving questionnaire and chart reviews to assess the prevalence and characteristics of driving difficulties in the following four groups of patients: TBI only, PTSD only, TBI + PTSD, and Neither (neither TBI nor PTSD). Compared with before deployment, 93% of OIF/OEF veterans seen in the polytrauma clinic reported more difficulties with driving in at least one domain, with the most common areas of difficulty being (1) problems with anger or impatience (82%), (2) general driving difficulties (65%), and (3) experiences with near misses (57%). Patients with PTSD (with or without TBI) reported the most significant driving impairments, whereas respondents with a history of only TBI endorsed driving difficulties similar to veterans without either diagnosis. Qualitative analysis of veterans' comments also revealed similar patterns. Self-reported driving problems were common among OIF/OEF returnees. Respondents who had a diagnosis of PTSD (with or without TBI) reported the most severe driving difficulties since returning from deployment. The association between PTSD and driving problems warrants further investigation.
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